Children offer suffer from difficulties going to sleep at bedtime or from wakening during the night and being unable to return to sleep. Studies have shown that 20-50% of infants, toddlers and preschool children experience problems of this sort at some point. If a young child has sleep problems, the whole family is often affected due to disturbance during the night and difficult behaviour during the day. Therefore there is a need to address sleep problems in children.
If childhood sleep problems are not addressed they can persist into later childhood and teenage years. Lack of good quality sleep in children has been linked to a variety of developmental and behavioural problems. Increased sleepiness has been linked to increased oppositional and inattentive behaviour, impaired verbal fluency and creativity, a reduction in the speed and accuracy at which tasks are completed and a decrease in the ability to perform abstract problem solving. A chronic lack of sleep is therefore damaging for a child's academic and social development and hence may disadvantage the child throughout their life. It is therefore clear that addressing childhood sleep problems early is necessary and has great benefits both for the child and for the rest of the family.
As children age, the types of sleep problems they can suffer from change. Newly born babies of up to around 2 months are not able to distinguish night from day and typically sleep for numerous short periods. From 2 months to about 2 years of age, children start to sleep for longer periods and have to learn to adjust their sleep patterns in order to sleep during the night and be active during the day. As the child learns how to sleep it may form maladaptive associations, for example associating the onset of sleep with receiving attention from a parent or carer. The child may then require such attention in order to initiate sleep at bedtime. It is normal for children to arouse 4 to 6 times during the night but if a child has formed an association between going to sleep and receiving attention from a carer, it may cry or wail until the carer comforts it. This causes disrupted sleep both for the parents or carer and for the child. An inappropriate or uncomfortable bedroom environment, that may be too hot or noisy, may also affect the sleep of children of this age.
As children become more independent from about to 2 to 5 years they often start to stall at bedtime, refuse to go to bed or leave their bedroom. This can be because the children seek attention from their parents or carer and may prioritise this over feelings of tiredness. If the parents or carers do not or inconsistently enforce a bed time for the child, older children in particular rapidly learn that they can get away with staying up later if they are difficult at bedtime. This often leads to the children not receiving the duration of sleep they require. These problems can be aggravated further by busy sleeping environments, such as a room shared with another child or sleep-incompatible behaviours such as late-night television watching. Once a child has developed inappropriate sleep habits they can be difficult for a parent or carer to address.
For school age children of 5 years and above, the imposition of a different weekday and weekend schedule can lead to sleeping excessively late during weekend mornings and being unable to readjust to a weekday routine. Furthermore, the presence of a television or video game system in the child's room, if used in the evening, can lead to a delay in the onset of sleep and accompanying problems with daytime sleepiness. If unaddressed these problems can have a deleterious effect on the performance of the child at school and in later life.
Fortunately, many sleep problems in children can be addressed by established behavioural means. By setting and enforcing appropriate sleep times, removing distractions, ensuring a good sleep environment and timing parental contact, the child's quality of sleep can be improved in the majority of cases. Behavioural programs of this nature are typically carried out by a sleep specialist who will work with the parents and child. Since the sleep problems of each child are different, the behavioural programs must be customised to the particular child. The role of the parent or carer is fundamental in teaching the children improved sleep habits but the parent or carer must be educated and trained in how to carry out the behavioural programs. This involves adhering strictly to the program of actions and keeping proper records. Complying with the program of actions can be difficult for the parent or carer, particularly if they do not see improved sleep behaviour in the child immediately. Furthermore, keeping accurate records of the child's sleep may be difficult for the parent or carer, particularly if they are suffering from sleep deprivation as a result of the child's poor sleep behaviour.
The parent or carer is normally trained by the sleep specialist who is also responsible for designing the behavioural program for the particular child, checking that the parents are adhering to the scheme and monitoring the progress of the child. Furthermore, the behavioural programs are often adapted based on the progress of the child which the sleep specialist will estimate from the parent or carer's records. Since keeping accurate records may be difficult for a parent or carer, it is clear that the effectiveness of the behavioural program may be reduced by inaccurate record keeping.
A typical behavioural program for a child with sleep problems may last weeks or months and entail many consultations with a sleep specialist. This can be expensive or unaffordable for the parent or carer and, since sleep problems in children are very common, there may be insufficient sleep specialists in the community to deal with all parents or carers who need advice.
It is clear therefore that there is a need for a device that can assist a parent or carer to monitor the sleep environment and behaviour of a child and to instruct the parent or carer in how to carry out effective behavioural programs to improve the sleep behaviour of a child.
The following references provide additional background information to the invention.
US Patent Documents
U.S. Pat. No. 4,640,034 Zisholtz (3 Feb. 1987)
U.S. Pat. No. 4,777,938 Sirota (18 Oct. 1988)
U.S. Pat. No. 7,127,074 Landa (24 Oct. 2006)
U.S. Pat. 5,479,939 Ogino (2 Jan. 1996)
US Patent Application 20070279234 Walsh (6 Dec. 2007)
US Patent Application 20070191692 Hsu (16 Aug. 2007)
European Patent Documents
1810710 (25 Jul. 2007)
2033681A1 (11 Mar. 2009)
World Patent Documents
WO 2005089649 (29 Sep. 2005)
Others
A Clinical Guide to Pediatric Sleep, J. Mindell & J. Owens (Lippincott Williams & Wilkins, 2003)
Sleep Problems in Children and Adolescents, G. Stores (Oxford University Press, 2009)
There exist a number of devices that are designed to assist children to sleep during the night. U.S. Pat. No. 4,640,034 ‘Mobile for infants’ describes a mobile to be placed above a child's bed or crib. The mobile responds to a child's crying by moving and playing comforting music or sound to distract a child. U.S. Pat. No. 4,777,938 ‘Babysitter toy for watching and instructing child’ describes a toy that is placed close to a child's bed and responds to a child's crying by playing music, reading a fairy story or making some motion so as to coerce the child to sleep. Published European patent application 2033681 describes a toy for a child that may include sensors and emits light or sound to coerce the child to sleep. Published US Patent Application 20070279234 describes a device emitting an automated light or audio cue in order to train a child to sleep at a particular time. Such devices have the disadvantage that they do not address the root cause of sleep problems in children and act only to mitigate sleep disruption. These devices do not make use of the fact that the parent or carer has the most influence over a child's sleep and is therefore the party that can have the most beneficial effect on the child. Therefore they are likely to be ineffective for children who have become accustomed to requiring the presence of their parents to sleep or who are accustomed to not sleeping until late at night.
U.S. Pat. No. 7,127,074 describes a baby monitor device that can assist a parent or carer in training a child to sleep by muting the sound of the child for a fixed period of time so the child's cries can be ignored. This device has the disadvantage that it does not contain a sensing element and is therefore unable to detect if the parent or carer is correctly carrying out the training program or if the training program is effective. Further, it cannot assist the parents in changing the timing of their contact with the child as its sleeping behaviour improves.
WO 2005/089649 (29 Sep. 2005) proposes an implantable medical device that can be implanted in a patient for use in the determination of the patient's sleep quality. The need to implant the device in the patient is however undesirable. The system is directed solely at improving a medical treatment, for example for chronic pain, and does not teach any system for use by a carer to assist with merely modifying sleep patterns of an individual in their care by any behavioural program.
EP 1810710 (25 Jul. 2007) proposes a sleeping state improvement system for improving the sleeping state of a user who is away from home. It has a memory unit carried by a user, a specification unit and a control unit. The specification unit specifies individual attributes of the user based on individual information, and the individual information is stored in the memory unit. The control unit controls an environment when the user is asleep based on the individual attribute information.
US 2007/0191692 (16 Aug. 2007) relates to a system for monitoring the quality of sleep of a person. The system comprises a sensor for sensing physiological signals such as snoring, breathing, body movement or body temperature. These signals are transmitted from the sensor to a data server via a wired or wireless connection. The signals are stored and analysed by the data server to determine when the person under test is awake or asleep, in deep or shallow sleep, duration of sleep etc.
Whilst there exists a number of devices which attempt to mitigate sleep problems in children, there remains a need for a device that can assist a parent or carer to monitor the sleep behaviour of a child and to instruct the parent or carer in how to carry out effective behavioural programs to improve the sleep behaviour of a child.